South Africa should use its G20 presidency to drive its own National Health Insurance system, says Helen Clark, former prime minister and health minister of New Zealand and now a member of the global leaders forum, The Elders.
Writing in Business Day, Clark pointed to the upcoming G20 Health Ministers summit – to be held in Polokwane – saying that this meeting presented an opportunity “not only to lead the global conversation on health and equity, but also to demonstrate concrete progress at home. So, as chair of the G20, this is the ideal time for SA to accelerate its National Health Insurance (NHI) reforms, with the aim of reaching universal health coverage (UHC).”
Praising the NHI Act as “one of the most ambitious social reforms in the country’s democratic history”, she said the time was ideal to “accelerate” its implementation.
She argued that the Covid pandemic showed that countries with strong, publicly financed systems performed better than those without them. She listed New Zealand as an example, whose system was “built on the simple principle that healthcare is a public good and a right, not a privilege”. This was an early example of what had become a worldwide trend, which many middle-income countries are now following.
UHC, she continued, would lead to better health outcomes, health security and pandemic preparedness, promote economic growth, reduce inequality and foster social solidarity and peace.
“Of course,” she continued, “such transformation will not be easy. Building an effective NHI system will require strong governance, sound public financial management and clear communication with citizens to maintain trust. There will be vested interests that resist change, and there will be complex technical challenges along the way. But the long-term benefits — for health, for equity, for the economy — vastly outweigh the short-term difficulties.”
Clark did not deal with the deficient state of public administration, the corruption that attended medical procurement in the public sector, South Africa’s narrow tax base, or the risks inherent in the NHI legislation, such as the influence it gave to the minister of health – a political office-bearer – to appoint the proposed institution’s board.
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